How does Exilis work?
Exilis is the safest, fastest, most effective way to volumetrically deliver radiofrequency energy (RF) to the deepest layers of the skin, allowing for a dual function of circumferential reduction of fatty adiposities to tightening of the skin on the body and face. When the cooling is on, the RF penetrates the deepest dermal layers and radiantly heats the adipose cells, causing them to increase their metabolic rate and release fatty acids from the cells. This occurs safely without an increase in serum cholesterol both short and long term. Exilis does not remove fat cells from the body, but rather, the RF ramps up the metabolism causing the adipocytes to release stored lipids. The collagen network surrounding the adipocytes contracts as well. Skin tightening occurs when the cooling is turned off and the heating is more superficial.
For whom is it indicated?
Exilis is indicated for anyone who wants a fast, no-downtime, painless procedure for tightening the skin of the face and body. Most people who come for Exilis treatments have specific, small areas of concern (such as the desire to reduce the circumference of the arms, or to reduce the appearance of loose skin of the arms), without undergoing the morbidity, downtime, and scarring of a surgical procedure. The procedure is wonderful for those individuals who want to maintain a lift and then work on a preventative program against aging by doing the procedure regularly. Most patients who are candidates for Exilis, or any radiofrequency skin tightening technology range from twenty four years of age to the mid seventies. After this age point, the collagen response to be as robust.
For whom is it contraindicated?
Radiofrequency skin tightening should not be carried out in any patient who has large amounts of metal in the region to be treated (artificial knees, hips, plates in the spine). A general rule is if they can have an MRI, they can have RF skin tightening. Pregnancy is also a contraindication, as well as cancer that is not in remission. Patients with pacemakers are obviously not able to be treated also. The most important contraindication is over-inflated patient expectations. Exilis will not produce the same results as a rhytidectomy, brachioplasty, or abdominoplasty. I suggest you not perform the procedure on individuals who have unrealistic expectations. No RF technology can compare to surgery (yet). Before every treatment, the patients are weighed, measured from a fixed body point (tip of the xyphoid process for the abdomen, tip of the ulna for the arms, from the ground up for the thighs), and photographed. This is good science, and it also allows you as a practitioner and the patient to decide if progress is being made. Usually, the most progress occurs between the second and third session.
How does it compare to other technologies ?
The Exilis is great for many reasons. First of all, there is a high patient satisfaction rate. Patients often start with one area, then they add additional areas when they see the great results that can be achieved. They would not do this if it didn’t work. Why spend extra time and money on a futile endeavour? Second, the Exilis is a fast procedure, it usually takes about a half hour, and no pre-medication is required. The patients literally jump out of the chair and head right back to work. Third, it is painless, and there is no downtime and there are no restrictions on activity afterwards. No compression garments or special hosiery is required. The skin stays pink for a while like you just jumped off the treadmill and then as the skin cools, the color returns to normal and some tightening is felt. Fourth, it is easily delegated to ancillary personnel, and it gives them time to connect to the patients that they would not otherwise have, allowing for a more personal connection, as well as an opportunity for cross-selling of other treatments or product suggestions. Fifth, the lack of a need for disposables makes it the perfect first choice selection for both a surgical and non-surgical cosmetic practice. The return on investment is high. Some surgeons that perform liposuction use the Exilis before and after surgery because they report that the Exilis treatment has a positive impact on the viscosity of the fat to be removed during the liposuction procedure, as well as positively impacting the skin tightening and lymphatic drainage after the procedure.
What does the treatment involve from an operator perspective?
The machine is very easy to operate, and the only requirement of the operator is to enjoy interacting with the patients. Each procedure area is roughly the size of the return pad. The body handpiece has a continuous skin surface thermometer monitoring the external skin temperature and alerts the operator if there is a break in full skin contact. Each treatment area takes about 10-15 minutes to perform (upper ab, lower ab, left flank, right flank, etc.) The display module is very easy to learn and understand, and we find that the patients are very eager to give us feedback as to what we can do better (usually they want to have a longer treatment, as long as they can take). Everyone is different. The most important thing staying focused, moving the applicator as slowly as possible without losing full contact with the skin will get the best results the fastest.
What can a patient expect during a treatment?
The patient can expect a gradual warming up of the skin until it feels a little too hot for comfort. At that point, the temperature is lowered to a tolerable level and the skin is maintained at an external temperature of 42 Celsius for the duration of the session. It is a fairly comfortable experience and all patients get through it with encouragement. No premedication is required. Numbing creams are contraindicated because they change the resistance of the skin. Once the procedure is completed, the skin remains warm and pink for a while after surgery.
How long a course is involved?
The current guidelines are one session every 7-10 days for a total of four sessions. Patients can do more sessions if they like. Invariably, the more they do, the better the result.
Are there any special considerations post care?
Not really. Just don’t go out and ruin all the hard work by going on a pizza and chocolate cake bender! As long as the patient maintains his or her usual diet and level of activity, the results can be lasting. Body shaping patients who hydrate well and get some exercise during the 2-3 days post sessions will move the most waste out of their bodies and experience the best results.
Are there any side effects?
Just the temporary pinkness that goes away post-procedure. It is not advisable to treat the buttock area itself because this has led to some undesired fat loss. Also, caution should be exercised when operating the body handpiece near bony areas such as the thoracic or pelvic girdle due to sensitivity.